Health Maintenance Organization Basics
HMOs are more restrictive than other managed care providers. HMOs only cover members if they visit doctors within the HMO insurer network. If there’s a specialist a member wants to see for a specific ailment and the physician is not in … read more…
Affordable Healthcare – health benefits
POS – Point Of Service plans ============================================= More flexible than HMOs, but they also require you to select a PCP. Advantages: – You may visit a doctor outside the network and still receive coverage; … read more…
Would passing Universal Healthcare kill of the economy and hope to …
WE will have the choice of the same doctors the same HMO’s, the same everything we have now, or to partake in another private plan or the same private plan offered to all government workers. You will still pay for the plan regardless of … read more…
From Google Blog Search
Search Failed
Sorry, the connection to the search server either timed out or is unavailable, please try your search again. read more…
From GoArticles.com
Open Question: HMO disaster, how can I get a claim paid without a referral?
My son had surgery a year and a half ago. He has two insurances, the PPO is the primary, the HMO is the secondary. I told the doctor’s office to get a referral for the HMO (my insurance). Now we are starting to get bills for the remainder that the 1st insurance company didn’t cover. Find out that the doctor’s office didn’t “believe” we needed a referral and never requested one. Now there are $1,000′s of bills not covered. The doctor’s office told me to contact insurance company number one (which I can’t it’s dad’s, son is from a previous marriage) and ask them to pay. I imagine they will laugh at that. What do I do? Sue? These bills are all in my name because I took him for his surgery and Dad won’t do anything. Are there any advocacy groups or someone in Illinois that help people like me?
Serious replies only please. Thanks!
Resolved Question: Which organization of Obama will be most successful?
ACORN
General Motors
Chrysler
or
All US Hospitals, Doctors offices HMO’s and Pharmaceutical companies combined?
Resolved Question: Insurance provider paid claims for an ineligible dependent Does the dependent now have to pay the paid claims?
Here’s the situuation:
My mom added me as a dependent and she thought I just needed to be a student in order to be on her medical insurance. She added me to her plan on 10/9/09 and she had 60 days (according to the benefit provider’s website) to submit documentation that I am eligible to participate. To further complicate matters, my mom found out that she must be providing at least HALF of my support and because I am single, living on my own and have a mortgage in my name, that would make me ineligible for the insurance benefit as a dependant. If claims were paid since the start of the plan year 1/1/10, and because I am not an eligible individual on her plan, would I be responsible for paying the paid claims even though the insurance company did not request the documentation BEFORE paying any claims for me?
I have read some laws about dependant coverage and COBRA if they become ineligible, but it seems that I have been ineligible from the start, despite a Benefit Administrator at her work advising her that i was eligible.From what I was reading, if I become ineligible, I can obtain COBRA benefits under the same provider and plan so long as I pay the premiums, which cannot be more than 102% of the premium costs for an individual that would qualify.
Here is some information that may help determin my case:
I live in Florida
I have had approximately $5000 in healthcare costs since 1/1/10 because of an echocardiogram ($3840), and several doctors visits with specialists.
The provider is an HMO providing insurance for a large employer (5000+ people)
Any information would be greatly appreciated.
If the issue is that healthcare costs too much why don’t doctors reduce their prices?
Posted by mvandenberg via FriendFeed
HEALTH CARE LOBBY HAS INVESTED HEAVILY IN THOSE WHO WILL ATTEND REFORM SUMMIT | Citizens for Responsibility and Ethics in Washington
Posted by silas216 via FriendFeed
I hope hospitals really look into Apple’s iPad. This could be a great tool for Nurses & Dr. Even HMO’s Doctors can use this tool.
Posted by poopstech via FriendFeed
But what if I actually get SICK!?!?
Posted by qqg via Ask MetaFilter
California sets rules for seeing doctors faster
Posted by abouey via FriendFeed
California Limits HMO Wait Times
Posted by keithrowland via Health News from Medical News Today
New Rules Set for H.M.O.’s in California – NYTimes.com
Posted by jtyost2 via delicious
RT @drsteventucker HMO should focus on the quality of care, not just improving waiting time! #doctors
Posted by smokefreeway via Twitter
Recently Being Discussed on FriendFeed
Leave a comment